Evaluating trauma scoring systems for patients presenting with gunshot injuries to a district-level urban public hospital in Cape Town, South Africa
African journal of emergency medicine (Print)
;
9(4): 193-196, 2019. ilus
Artículo
en Inglés
| AIM
| ID: biblio-1258712
ABSTRACT
Introduction:
Trauma scoring systems are widely used in emergency settings to guide clinical decisions and to predict mortality. It remains unclear which system is most suitable to use for patients with gunshot injuries at district-level hospitals. This study compares the Triage Early Warning Score (TEWS), Injury Severity Score (ISS), Trauma and Injury Severity Score (TRISS), Kampala Trauma Score (KTS) and Revised Trauma Score (RTS) as predictors of mortality among patients with gunshot injuries at a district-level urban public hospital in Cape Town, South Africa.Methods:
Gunshot-related patients admitted to the resuscitation area of Khayelitsha Hospital between 1 January 2016 and 31 December 2017 were retrospectively analysed. Receiver Operating Characteristic (ROC) analysis were used to determine the accuracy of each score to predict all-cause in-hospital mortality. The odds ratio (with 95% confidence intervals) was used as a measure of association.Results:
In total, 331 patients were included in analysing the different scores (abstracted from database nâ¯=â¯431, excluded missing files nâ¯=â¯16, non gunshot injury nâ¯=â¯10, <14 years nâ¯=â¯1, information incomplete to calculate scores nâ¯=â¯73). The mortality rate was 6% (nâ¯=â¯20). The TRISS and KTS had the highest area under the ROC curve (AUC), 0.90 (95% CI 0.83-0.96) and 0.86 (95% CI 0.790.94), respectively. The KTS had the highest sensitivity (90%, 95% CI 68-99%), while the TEWS and RTS had the highest specificity (91%, 95% CI 8794% each).Conclusions:
None of the different scoring systems performed better in predicting mortality in this high-trauma burden area. The results are limited by the low number of recorded deaths and further studies are needed
Buscar en Google
Índice:
AIM (África)
Asunto principal:
Sudáfrica
/
Heridas y Lesiones
/
Heridas por Arma de Fuego
/
Hospitales Públicos
Tipo de estudio:
Estudio pronóstico
País/Región como asunto:
Africa
Idioma:
Inglés
Revista:
African journal of emergency medicine (Print)
Año:
2019
Tipo del documento:
Artículo
Similares
MEDLINE
...
LILACS
LIS